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Rehabilitation Practice and Science

Translated Title

經由小面關節注射來控制復發性肌膜引痛點：病例報告

Abstract

Recurrent myofascial trigger points (MTrPs) may be caused by or associated with chronic soft tissue lesion(s) which can not be easily identified. We hereby report a case of recurrent myofascial trigger points in the upper back muscles, which were successfully controlled after one treatment of cervical facet injection.This patient was a 40-year-old man who had suffered from chronic left upper back pain and soreness with tingling sensation and back stiffness for six months. He had active MTrPs in the left levator scapulae, left rhomboid major and minor, left upper trapezius, and left serratus posterior superior muscles. Spurling sign was negative. Neurological examination was within normal limits. Electromyographic examination revealed evidence of chronic C6 and C7 radiculopathies in both sides. MRI of the cervical spine showed mild disc bulging at C5-6 and C6-7 levels. He was firstly treated conservatively with physical therapy including heat therapy and cervical traction. He also received acupuncture and lidocaine injection to the active MTrPs, which showed only temporary effect. Further examination revealed severe tenderness in the left C5-6 facet joint, which was correlated with finding of CT scan. MTrPs pain in the left upper back could be reproduced during compression of the facet joint. Therefore, injection with betamethasone 4 mg plus 1% lidocain 0.5 cc was performed to the left C5-6 facet. Immediately after injection, all the MTrPs became inactive (pain free) . In a follow-up examination 2 months later, no active MTrPs could be identified. No recurrence of symptoms was reported in a follow up phone call 15 months later. It is suggested that when a patient has recurrent MTrPs in the upper back, careful examination for facet joints to find possible association of facet lesion and MTrPs and to offer appropriate local injection may be very helpful to control the recurrent MTrPs.

Language

English

First Page

41

Last Page

45

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